If you like your medications, you can pay for your medications

We’ve seen that Obamacare is causing millions of people to lose their health care plan, whether they liked it or not. And we’ve learned that Obamacare likely will cause millions to lose access to their doctors and hospitals of choice. In addition, Obamacare has led to ballooning deductible levels.

Now, the Washington Post reports that Obamacare likely will raise significantly what the chronically ill will have to pay for costly medications:

The nation’s new health-care law says insurers can’t turn anyone away, even people who are sick. But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.

Some plans sold on the online insurance exchanges, for instance, don’t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance — sometimes more than $1,000 a month. . . .

People who expected the new plans to provide pharmaceutical coverage comparable to that of employer-sponsored plans have been disappointed. In recent years, employers have compelled workers to pick up a growing share of the costs, especially for brand-name drugs.

But insurers selling policies on the exchanges have pared their drug benefits significantly more, according to health advocates, patients and industry analysts. The plans are curbing their lists of covered drugs and limiting quantities, requiring prior authorizations and insisting on “fail first” or “step therapy” protocols that compel doctors to prescribe a certain drug first before moving on to another — even if it’s not the physician’s and patient’s drug of choice. . . .

“2014 is going to be a scary year. People are going to have to stop taking medicines they are already stable on because of this,” said [Daniel] Kantor, the immediate past president of the Southern MS Consortium, a group of doctors, social workers and advocates who work with patients with the condition.

As you can see, the Post casts insurance companies as the villains of this piece. But Obamacare establishes minimum levels of coverage for drugs, and the Post does not claim that insurers are failing to meet these standards.

Thus, the blame lies with Obamacare which, as the Post eventually acknowledges, leaves insurers with only a few ways to try to balance the costs and risks associated with covering the chronically ill.

The final twist is that, inspired by what is occurring on the exchanges, employers may soon adopt some of the stringent prescription drug benefit designs used in those plans. “We are already seeing interest,” one leading health care analyst told the Post.

Naturally, the powerful AIDS lobby has noticed the impact of Obamacare on what people with HIV will have to pay for drugs. It is not amused. Blaming the insurance companies won’t be sufficient to satisfy this constituency.